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CLEVELAND, Feb. 26 -- In their final debate before critical primaries in Ohio and Texas, Sens. Barack Obama and Hillary Rodham Clinton clashed sharply on familiar ground, arguing Tuesday night over who has the better health-care plan, who has been right about Iraq and who would move most aggressively to rethink trade policy as president.

In contrast to their debate five days ago in Texas, Clinton and Obama butted heads from the opening moments, starting with a clash over whether the senator from Illinois had mischaracterized her plan for universal health care in his campaign mailings, and continuing throughout the 90-minute session.

"We should have a good debate that uses accurate information, not false, misleading and discredited information, especially on something as important as whether or not we will achieve quality, affordable health care for everyone," said Clinton (N.Y.).

Obama pushed back with equal aggressiveness. "Senator Clinton has, in her campaign at least, has constantly sent out negative attacks on us, e-mail, robo-calls [prerecorded telephone messages], fliers, television ads, radio calls, and we haven't whined about it, because I understand that's the nature of this campaign," he said.

The tone of the debate was generally civil but rarely relaxed. Throughout, there was no mistaking the stakes involved for the candidates, especially Clinton, who has lost every contest since the Super Tuesday primaries and caucuses of Feb. 5. Polls show Clinton and Obama in a very competitive race in Texas, while Clinton holds a narrow lead in Ohio. Obama has closed the gap with Clinton in both states.

Her husband, former president Bill Clinton, has said that she must win both Ohio and Texas in order to keep her campaign going, and throughout the debate Clinton pressed her rival and displayed the greater sense of urgency about getting her points across. Unless she wins both states by wide margins, Obama will still hold a lead in pledged delegates to the national convention.

The debate -- the 20th involving the Democratic presidential candidates in the past 10 months -- did little to change the overall shape of the race, which may play to Obama's advantage but will also make the final six days of campaign crucial to both candidates. Earlier in the day, Obama picked up the endorsement of Sen. Christopher J. Dodd of Connecticut, who dropped out of the race for the nomination in January.

Clinton's frustration with her political situation flashed through early on, when she noted that she seemed to always get the first questions in these debates and made a reference to a "Saturday Night Live" skit aired last weekend that mocked reporters for fawning over Obama. "Maybe we should ask Barack if he's comfortable and needs a pillow," she said.

Obama did not respond to that swipe, but he missed few other opportunities to parry Clinton's charges. Toward the end of the debate he used humor to counter Clinton, who had interjected herself into a question about whether Obama had been strong enough in stating his objections to Louis Farrakhan, the controversial leader of the Nation of Islam.

Asked to respond to an endorsement of his candidacy by Farrakhan, Obama described the Chicago figure's anti-Semitic comments as "reprehensible." Adding that "I obviously cannot censor him," Obama said he had not sought the support and would do nothing to make use of it.

"I have been very clear in my denunciation" of Farrakhan's past anti-Semitic remarks, Obama said.

Clinton jumped in to note that, in her 2000 Senate campaign, she had gone to greater lengths to distance herself from people who had made anti-Semitic remarks. "There's a difference between denouncing and rejecting," Clinton said, implying that Obama had not gone far enough. "I just think we've got to be even stronger."